Peer-reviewed article
Neuroscience meets nurture: challenges of prematurity and the critical role of family-centred and developmental care as a key part of the neuroprotection care bundle
Roopali Soni, Charlotte Tscherning, Nicola Jayne Robertson ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This review examines how premature birth disrupts normal fetal brain development and leads to neurological complications in children. While medical advances have improved survival rates at lower gestational ages, premature infants still face significant developmental challenges and neurological disability. The authors argue that family-centred and developmental care approaches are essential non-medical strategies to protect brain development and should be integrated into comprehensive neuroprotection care for preterm infants.
Key points
- Preterm birth disrupts normal fetal brain development trajectories, creating a new phenotype of brain injury combining destructive and dysmaturational effects
- Although severe neurological disability rates have decreased, overall morbidity from premature birth remains a large global burden with significant financial costs
- Family-centred and developmental care strategies offer basic, sustainable, and effective non-medical approaches to improve neurodevelopmental outcomes
- These care strategies should be considered part of a comprehensive neuroprotection care bundle alongside medical and cell-based therapies
Limitations
This is a narrative review that does not present original research data or evaluate the effectiveness of specific interventions through empirical testing. It cannot provide quantitative evidence about outcomes or comparative effectiveness of different care approaches.
Abstract
Advances in neonatal-perinatal medicine have resulted in increased survival at lower gestations. Although the incidence of germinal matrix haemorrhage-intraventricular haemorrhage and cystic periventricular leucomalacia is reducing, a new phenotype of preterm brain injury has emerged consisting of a combination of destructive and dysmaturational effects. Consequently, severe neurological disability is reported at a lower rate than previously, but the overall morbidity associated with premature birth continues to present a large global burden and contributes significantly to increased financial costs to health systems and families. In this review, we examine the developmental milestones of fetal brain development and how preterm birth can disrupt this trajectory. We review common morbidities associated with premature birth today. Although drug-based and cell-based neuroprotective therapies for the preterm brain are under intense study, we outline basic, sustainable and effective non-medical, family-centred and developmental care strategies which have the potential to improve neurodevelopmental outcomes for this population and need to be considered part of the future neuroprotection care bundle.